Doral / Karlsson / Nyland Intraarticular Fractures

Minimally Invasive Surgery, Arthroscopy
1. Auflage 2019
ISBN: 978-3-319-97602-0
Verlag: Springer International Publishing
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, 432 Seiten

This superbly illustrated book is a comprehensive and detailed guide to the contemporary arthroscopic management of intraarticular fractures. The opening section addresses a variety of basic aspects and key issues, including the difficulties posed by intraarticular fractures, principles of fixation, cartilage healing, and rehabilitation. The minimally invasive surgical techniques appropriate to individual types of fracture are then fully described and depicted, covering fractures of the shoulder and elbow, wrist, pelvis and hip, knee, and ankle. Guidance is also provided on avoidance and management of complications and rehabilitation. The closing section addresses relevant miscellaneous issues, including arthroscopic management of temporomandibular joint fractures and extended indications for endoscopy-assisted fracture fixation. This volume will be of value for both trainee and experienced surgeons when treating patients with these complex fractures.

Autoren/Hrsg.

Doral, Mahmut Nedim

Karlsson, Jón

Nyland, John

Benedetto, Karl Peter

Inhaltsverzeichnis

1;Foreword;6
2;Preface;8
3;Preface;10
4;Preface;11
5;Acknowledgments;12
6;Contents;13
7;Part I: General Knowledge;17
7.1;1: Natural History of Bone Bruise;18
7.1.1;1.1 Introduction;18
7.1.2;1.2 Bone Bruise Classification;19
7.1.3;1.3 Bone Bruise Location and Mechanism;19
7.1.4;1.4 Clinical and Histological Findings;21
7.1.5;1.5 The Natural Course;22
7.1.6;1.6 Treatment;23
7.1.7;1.7 Conclusion;23
7.1.8;References;24
7.2;2: Arthroscopic Treatment Vs. Open Surgery in Intra-articular Fractures;26
7.2.1;2.1 Background;26
7.2.2;2.2 Articular Fracture Reduction;27
7.2.3;2.3 Associated Soft Tissue Injuries;27
7.2.4;2.4 Loose Bodies;28
7.2.5;2.5 Articular Degenerative Changes;28
7.2.6;2.6 Conclusion;29
7.2.7;References;29
7.3;3: Intra-articular Fractures: Principles of Fixation;30
7.3.1;3.1 Introduction;30
7.3.2;3.2 Classification;30
7.3.3;3.3 Unique Features of Intra-articular Fractures;33
7.3.4;3.4 Imaging of Intra-Articular Fractures;33
7.3.5;3.5 Basic Principles of Management of Intra-articular Fractures;33
7.3.6;3.6 Importance of Step-Offs/Gaps;35
7.3.7;3.7 Healing of Articular Cartilage;36
7.3.8;3.8 Conclusion;37
7.3.9;References;37
7.4;4: Intra-articular Fractures: Philosophy of Minimally Invasive Fixation;39
7.4.1;4.1 Minimally Invasive Fixation;39
7.4.2;4.2 Intra-articular Fractures;40
7.4.2.1;4.2.1 Description;40
7.4.2.2;4.2.2 Problems Related to the Treatment;41
7.4.2.3;4.2.3 Treatment Planning;41
7.4.3;4.3 Conclusion;42
7.4.4;References;42
7.5;5: Biologic Solutions for Articular Cartilage Healing;44
7.5.1;5.1 Introduction;44
7.5.2;5.2 Articular Cartilage Surgical Treatment;45
7.5.2.1;5.2.1 Reconstructive Procedures;45
7.5.2.2;5.2.2 Tissue Engineering and Scaffold-Based Procedures;46
7.5.3;5.3 Nonsurgical Articular Cartilage Treatment;49
7.5.3.1;5.3.1 Injections;49
7.5.3.2;5.3.2 New Injective Biological Approaches;50
7.5.4;5.4 Conclusion;50
7.5.5;References;50
7.6;6: Rehabilitation Principles Following Minimally Invasive Fracture Fixation;54
7.6.1;6.1 Introduction;54
7.6.2;6.2 Postsurgical Malalignment, Segment Length, or Joint Surface Inclination Changes;54
7.6.3;6.3 Healing Potential;55
7.6.4;6.4 Articular Surface Congruency;56
7.6.5;6.5 Potential Stress Shielding or Stress Riser from Fixation Hardware;57
7.6.6;6.6 Patient Expectations “Realistic or Not”;57
7.6.7;6.7 Optimizing Full Kinematic/Kinetic Chain Function;57
7.6.8;6.8 Patient/Client Understanding, the Importance of Therapeutic Lessons;58
7.6.9;6.9 Optimizing Metabolic Energy System Function;59
7.6.10;6.10 Repetitive Microtraumatic, Acute Isolated, or Polytraumatic Intra-articular Fractures;59
7.6.11;6.11 Pain;59
7.6.12;6.12 Gender, Genetics, Lifestyle, and Age;60
7.6.13;6.13 Therapeutic Exercise to Improve Function and Cognitive Appraisal: Psychobehaviors;61
7.6.14;6.14 Therapeutic Exercise and Patient Education;64
7.6.15;6.15 Objective and Subjective Function Assessments;66
7.6.16;6.16 Sufficient Follow-up;67
7.6.17;6.17 Conclusion;67
7.6.18;References;68
7.7;7: Arthroscopic Treatment Vs. Open Surgery in Intra-articular Fractures;71
7.7.1;7.1 Calcaneus and Talus Fractures;73
7.7.2;7.2 Ankle Fractures;73
7.7.3;7.3 Knee Fractures;74
7.7.4;7.4 Hip Fractures;77
7.7.5;7.5 Bennett Fractures;77
7.7.6;7.6 Wrist Fractures;77
7.7.7;7.7 Elbow Fractures;78
7.7.8;7.8 Shoulder Fractures;78
7.7.9;7.9 Conclusion;79
7.7.10;References;79
8;Part II: Arthroscopic Management of Shoulder and Elbow Fractures;83
8.1;8: Arthroscopic Treatment of Acromioclavicular Dislocations;84
8.1.1;8.1 Introduction;84
8.1.2;8.2 Anatomy and Biomechanics;84
8.1.3;8.3 Mechanism of Injury;85
8.1.4;8.4 Classification;85
8.1.5;8.5 Clinical Evaluation;86
8.1.6;8.6 Radiographic Evaluation;86
8.1.7;8.7 Treatment;87
8.1.7.1;8.7.1 Arthroscopy-Assisted Techniques;88
8.1.7.2;8.7.2 Arthroscopic Technique;91
8.1.8;8.8 Complications;93
8.1.9;8.9 Conclusion;94
8.1.10;References;94
8.2;9: The Arthroscopy-Assisted Anatomical Reconstruction of Acromioclavicular and Coracoclavicular Ligament in Chronic Acromioclavicular Joint Dislocation;98
8.2.1;9.1 Introduction;98
8.2.2;9.2 Surgical Technique;99
8.2.2.1;9.2.1 Imaging and Diagnosis;99
8.2.2.2;9.2.2 Preoperative Set-Up;100
8.2.2.3;9.2.3 Graft Harvesting: Preparation;100
8.2.2.4;9.2.4 Portal Placement: Arthroscopy Diagnostic;100
8.2.2.5;9.2.5 Acromioclavicular Joint Preparation;101
8.2.2.6;9.2.6 Reduction: Temporary Fixation;102
8.2.2.7;9.2.7 Coracoid Process Preparation: Graft Sling Passage;102
8.2.2.8;9.2.8 Acromion-Clavicle Bone Tunnel Preparation;102
8.2.2.9;9.2.9 Graft Passage: Fixation;103
8.2.2.10;9.2.10 Closure;105
8.2.3;9.3 Post-Operative Care;105
8.2.4;9.4 The Procedure Rationale;105
8.2.5;9.5 Conclusion;106
8.2.6;References;107
8.3;10: Distal Clavicle Fractures;108
8.3.1;10.1 Introduction;108
8.3.2;10.2 Diagnosis;110
8.3.2.1;10.2.1 Clinical Examination;110
8.3.2.2;10.2.2 Radiological Imaging;111
8.3.3;10.3 Treatment Modalities;111
8.3.3.1;10.3.1 Nonsurgical Treatment;111
8.3.3.2;10.3.2 Surgical Treatment;111
8.3.4;10.4 Author’s Preferred Surgical Management;112
8.3.5;10.5 Postoperative Treatment;113
8.3.6;10.6 Conclusion;114
8.3.7;References;114
8.4;11: Glenoid Fractures;116
8.4.1;11.1 Introduction;116
8.4.2;11.2 Glenoid Anatomy;116
8.4.3;11.3 Pathomechanics and Fracture Types;117
8.4.4;11.4 Epidemiology;118
8.4.5;11.5 Treatment Indications;119
8.4.6;11.6 Surgical Treatment;120
8.4.6.1;11.6.1 Arthroscopic Surgical Technique;120
8.4.7;11.7 Results of Treatment, Complications, and Unanswered Questions;122
8.4.8;11.8 Conclusion;125
8.4.9;References;125
8.5;12: Arthroscopic Treatment of Greater Tuberosity Fractures of the Proximal Humerus;127
8.5.1;12.1 Background;127
8.5.2;12.2 Surgical Technique;127
8.5.3;12.3 Rehabilitation;130
8.5.4;12.4 Outcomes;130
8.5.5;12.5 Conclusion;130
8.5.6;References;130
8.6;13: Arthroscopy-Assisted Reduction-Internal Fixation in Greater and Lesser Humeral Tuberosity Fracture;132
8.6.1;13.1 Clinical and Imaging Evaluation;133
8.6.2;13.2 Indication for Surgical Intervention;134
8.6.3;13.3 Surgical Technique: Arthroscopy-Assisted Humeral Tuberosity Fracture Fixation;136
8.6.3.1;13.3.1 Position: Portal Placement;136
8.6.3.2;13.3.2 Diagnostic Arthroscopy: Subacromial Decompression;136
8.6.3.3;13.3.3 Greater Tuberosity Fracture Exposure: Fragment Identification—Reduction and Fixation;136
8.6.3.4;13.3.4 Lesser Tuberosity Fracture Exposure: Fragment Identification—Reduction and Fixation;139
8.6.4;13.4 Postoperative Rehabilitation;142
8.6.5;13.5 Discussion;143
8.6.6;References;143
8.7;14: Arthroscopic-Assisted Surgery of the Distal Humeral Fractures;145
8.7.1;14.1 Introduction;145
8.7.2;14.2 Classifications;145
8.7.3;14.3 Diagnosis;147
8.7.3.1;14.3.1 Mechanism of Injury;147
8.7.3.2;14.3.2 Clinical Diagnosis;148
8.7.3.3;14.3.3 Imaging;148
8.7.4;14.4 Treatment;149
8.7.5;14.5 Operative Setup and Patient Positioning;150
8.7.6;14.6 Portal Placement and Surgical Approach;150
8.7.7;14.7 Surgery;151
8.7.8;14.8 Conclusion;153
8.7.9;References;154
8.8;15: Radial Head and Olecranon Process Fractures;156
8.8.1;15.1 Epidemiology;156
8.8.2;15.2 Diagnosis;156
8.8.3;15.3 Imaging;157
8.8.4;15.4 Classification;157
8.8.5;15.5 Treatment;158
8.8.5.1;15.5.1 Radial Head Fractures;158
8.8.6;15.6 Complex Elbow and Forearm Injuries;158
8.8.7;15.7 Olecranon Process Fractures;158
8.8.8;15.8 Tension Band Wire/Cannulated Screw;159
8.8.9;15.9 Plating;159
8.8.10;15.10 Arthroscopic Radial Head Fixation;159
8.8.11;15.11 Conclusion;159
8.8.12;References;160
8.9;16: Shoulder Rehabilitation After Minimal Invasive Surgery Around Shoulder Joint;162
8.9.1;16.1 Rehabilitation After Proximal Humerus Fracture Surgery;162
8.9.2;16.2 Rehabilitation After Acromioclavicular Joint Dislocation Surgery;163
8.9.2.1;16.2.1 Phase I: 0–3 Weeks Post-surgery;163
8.9.2.2;16.2.2 Phase II: 4–6 Weeks Post-surgery;166
8.9.2.3;16.2.3 Phase III: 6–8 Weeks Post-surgery;167
8.9.3;References;170
8.10;17: Rehabilitation After Minimally Invasive Fixation of Elbow Fractures;172
8.10.1;17.1 General Rehabilitation Guidelines;172
8.10.2;17.2 Phases of the Rehabilitation Program;172
8.10.2.1;17.2.1 Phase I (Weeks 0–3);173
8.10.2.2;17.2.2 Phase II (Weeks 4–7);175
8.10.2.3;17.2.3 Phase III (Weeks 8–14);176
8.10.2.4;17.2.4 Phase IV (Weeks 15–30);176
8.10.3;17.3 Conclusion;176
8.10.4;References;177
9;Part III: Arthroscopic Management of Wrist Fractures;178
9.1;18: Distal Radius Fractures;179
9.1.1;18.1 Introduction;179
9.1.2;18.2 Intra-articular Distal Radius Fracture;179
9.1.3;18.3 Role of Wrist Arthroscopy for Treating Intra-articular Distal Radius Fractures;180
9.1.4;18.4 Technique;180
9.1.5;18.5 Radial Styloid Process Fractures;182
9.1.6;18.6 Three-Part Fractures;183
9.1.7;18.7 Four-Part Fractures;183
9.1.8;18.8 Conclusion;184
9.1.9;References;184
9.2;19: Distal Radius Fractures with Metaphyseal Involvement: “Minimally Invasive Volar Plate Osteosynthesis”;185
9.2.1;19.1 Introduction;185
9.2.2;19.2 Anatomical and Biomechanical Concepts;186
9.2.3;19.3 Surgical Technique;186
9.2.4;19.4 Rehabilitation Protocols;189
9.2.5;19.5 Discussion;191
9.2.6;References;192
9.3;20: Arthroscopic Treatment of Scaphoid Fractures;194
9.3.1;20.1 Diagnosis and Mechanism of Injury;194
9.3.2;20.2 Anatomy;194
9.3.3;20.3 Fracture Types;195
9.3.4;20.4 Fracture Treatment;195
9.3.5;20.5 Open Versus Arthroscopic Surgical Treatment;196
9.3.6;20.6 Grafting;198
9.3.7;20.7 Conclusion;198
9.3.8;References;199
9.4;21: Carpal Fractures Other Than the Scaphoid;200
9.4.1;21.1 Introduction;200
9.4.2;21.2 Anatomy;200
9.4.3;21.3 Triquetral Fractures;201
9.4.4;21.4 Hamate Fractures;202
9.4.5;21.5 Lunate Fractures;202
9.4.6;21.6 Trapezium Fractures;203
9.4.7;21.7 Capitate Fractures;204
9.4.8;21.8 Trapezoid Fractures;204
9.4.9;21.9 Pisiform Fractures;205
9.4.10;21.10 Conclusion;205
9.4.11;References;206
9.5;22: Rehabilitation After Minimally Invasive Fixation of Hand Fractures;207
9.5.1;22.1 Introduction;207
9.5.2;22.2 Advantages of Minimally Invasive Procedures;207
9.5.3;22.3 Assessment;208
9.5.3.1;22.3.1 Inspection and Palpation;208
9.5.3.2;22.3.2 Pain;208
9.5.3.3;22.3.3 Range of Motion;208
9.5.3.4;22.3.4 Edema;208
9.5.3.5;22.3.5 Muscle Testing;208
9.5.3.6;22.3.6 Grip and Pinch Strength;208
9.5.3.7;22.3.7 Functional Tests and Scales;208
9.5.4;22.4 Rehabilitation;209
9.5.4.1;22.4.1 Edema Management;209
9.5.4.2;22.4.2 Proprioceptive Input;209
9.5.4.3;22.4.3 Scar Tissue Management;211
9.5.4.4;22.4.4 Pain Management;211
9.5.4.5;22.4.5 Manual Therapy;212
9.5.4.6;22.4.6 Orthotics;213
9.5.5;22.5 Therapeutic Exercise Regimes;213
9.5.5.1;22.5.1 Tendon-Gliding Exercises;213
9.5.5.2;22.5.2 Grip and Pinch Exercises;213
9.5.5.3;22.5.3 Muscle Reeducation;215
9.5.6;22.6 Conclusion;216
9.5.7;References;216
10;Part IV: Arthroscopic Management of Pelvis and Hip Fractures;218
10.1;23: Arthroscopic Management of Acetabular Fractures;219
10.1.1;23.1 Introduction;219
10.1.2;23.2 Acetabular Fractures;219
10.1.3;23.3 Current Role of Hip Arthroscopy in the Treatment of Acetabular Fractures;220
10.1.3.1;23.3.1 Removal of Fragments;220
10.1.3.2;23.3.2 Fracture Fixation;221
10.1.3.3;23.3.3 Diagnosis;222
10.1.3.4;23.3.4 Direct Acetabular Visualization to Prevent Screw Penetration;224
10.1.4;23.4 Limitations of Hip Arthroscopy in the Treatment of Acetabular Fracture;224
10.1.4.1;23.4.1 Postoperative Care;225
10.1.4.2;23.4.2 Complications;225
10.1.5;23.5 Conclusion;225
10.1.6;References;226
10.2;24: Arthroscopic Reduction and Internal Fixation of Femoral Head Fractures;228
10.2.1;24.1 Introduction;228
10.2.2;24.2 Femoral Head Fractures;228
10.2.2.1;24.2.1 Preoperative Planning;229
10.2.2.1.1;24.2.1.1 Experience;229
10.2.2.1.2;24.2.1.2 Game Plan/Contingencies;229
10.2.2.1.3;24.2.1.3 Femoroacetabular Impingement (FAI) Considerations;229
10.2.2.2;24.2.2 Consent;230
10.2.2.3;24.2.3 Equipment;231
10.2.2.4;24.2.4 Setup;231
10.2.2.5;24.2.5 Traction;231
10.2.2.6;24.2.6 Portals;231
10.2.2.7;24.2.7 Fluid Pressure;231
10.2.2.8;24.2.8 Arthroscopic Reduction;232
10.2.2.9;24.2.9 Arthroscopic Internal Fixation;232
10.2.2.10;24.2.10 Dynamic Arthroscopic and Fluoroscopic Testing;232
10.2.2.11;24.2.11 Postoperative Considerations;232
10.2.3;24.3 Femoral Head Malunions;233
10.2.4;24.4 Conclusion;234
10.2.5;References;234
10.3;25: The Role of Hip Arthroscopy in Posttraumatic Hip Dislocation;236
10.3.1;25.1 Imaging Limitations and the Value of Diagnostic Hip Arthroscopy;236
10.3.2;25.2 Indications for Hip Arthroscopy After Dislocation;237
10.3.2.1;25.2.1 Loose Bodies;237
10.3.2.2;25.2.2 Labral Tears;238
10.3.2.3;25.2.3 Osteochondral Lesions;238
10.3.2.4;25.2.4 The Femoroacetabular Impingement (FAI) Implication;239
10.3.2.5;25.2.5 Ligamentum Teres Rupture;239
10.3.3;25.3 Interpretation of the Available Literature;240
10.3.4;25.4 Complications;240
10.3.5;25.5 Cautionary Note;241
10.3.6;25.6 Conclusion;241
10.3.7;References;241
10.4;26: Posterior Acetabular Rim Fractures;243
10.4.1;26.1 Introduct?on;243
10.4.2;26.2 Case;244
10.4.3;26.3 Discussion;246
10.4.4;26.4 Conclusion;248
10.4.5;References;248
11;Part V: Arthroscopic Management of Knee Fractures;250
11.1;27: Arthroscopy-Assisted Retrograde Nailing of Femoral Shaft Fractures;251
11.1.1;27.1 Arthroscopy-Assisted Retrograde Femoral Nailing of Femoral Shaft Fractures;251
11.1.1.1;27.1.1 Advantages;251
11.1.1.2;27.1.2 Surgical Technique;252
11.1.2;27.2 Arthroscopy-Assisted Removal of Retrograde Femoral Nail;256
11.1.3;27.3 Limitations;256
11.1.4;27.4 Conclusion;256
11.1.5;References;257
11.2;28: The Distal Femur Fractures;258
11.2.1;28.1 Introduction;258
11.2.2;28.2 Classification;258
11.2.3;28.3 Treatment;258
11.2.4;28.4 Preferred Intramedullary Nailing Surgical Technique;264
11.2.5;28.5 Arthroscopy-Assisted Reduction and Internal Fixation: Femoral Condylar Fracture (Type B3 Hoffa Fracture);265
11.2.6;28.6 Conclusion;265
11.2.7;References;265
11.3;29: Eminentia Fractures;267
11.3.1;29.1 Introduction;267
11.3.2;29.2 Indications;267
11.3.3;29.3 Surgical Technique;267
11.3.3.1;29.3.1 Setup;267
11.3.3.2;29.3.2 Fracture Reduction;269
11.3.3.3;29.3.3 Screw Fixation;270
11.3.4;29.4 Rehabilitation;271
11.3.5;29.5 Conclusion;272
11.3.6;References;272
11.4;30: Eminentia Fractures: Transquadricipital Approach;273
11.4.1;30.1 Introduction;273
11.4.2;30.2 Clinical Evaluation and Classification;273
11.4.3;30.3 Management;274
11.4.3.1;30.3.1 Nonsurgical Treatment;274
11.4.3.2;30.3.2 Surgical Treatment;274
11.4.4;30.4 Transquadricipital Tendinous Arthroscopic Approach;275
11.4.4.1;30.4.1 Surgical Preparation;275
11.4.4.2;30.4.2 Arthroscopic Evaluation of the Joint and Reduction of the Fracture;275
11.4.5;30.5 Conclusion;277
11.4.6;References;277
11.5;31: Knee Soft Tissue Injuries Combined with Tibial Plateau Fractures;280
11.5.1;31.1 Introduction;280
11.5.2;31.2 Imaging;281
11.5.3;31.3 Management;281
11.5.3.1;31.3.1 Meniscal Injuries;281
11.5.3.2;31.3.2 Cruciate Ligament Injuries;281
11.5.3.3;31.3.3 Collateral Ligament Injuries;282
11.5.4;31.4 Outcome;282
11.5.5;31.5 Conclusion;282
11.5.6;References;283
11.6;32: Arthroscope-Assisted Surgical Treatment of Patellar Fractures;285
11.6.1;32.1 Surgical Technique;286
11.6.2;32.2 Discussion;289
11.6.3;32.3 Conclusion;290
11.6.4;References;290
11.7;33: Patella Fractures by Different Techniques;292
11.7.1;33.1 Introduction;292
11.7.2;33.2 Analysis of the Literature;294
11.7.3;33.3 Screw Fixation;294
11.7.4;33.4 Cerclage and Tension Band Wiring Technique;295
11.7.5;33.5 Screws and Tension Band;296
11.7.6;33.6 Conclusion;298
11.7.7;References;298
11.8;34: Articular Cartilage Injuries Associated with Patellar Dislocation;300
11.8.1;34.1 Introduction/Epidemiology;300
11.8.2;34.2 Imaging;301
11.8.3;34.3 Management;301
11.8.4;34.4 Outcomes;304
11.8.4.1;34.4.1 Clinical Outcomes;304
11.8.4.2;34.4.2 Chondral Lesion Progression;304
11.8.4.3;34.4.3 Osteoarthritis;305
11.8.5;34.5 Conclusion;305
11.8.6;References;305
12;Part VI: Arthroscopic Management of Ankle Fractures;308
12.1;35: Arthroscopy-Assisted Syndesmotic Reduction in Ankle Fractures;309
12.1.1;35.1 Introduction;309
12.1.2;35.2 Preoperative Assessment;310
12.1.3;35.3 Clinical Assessment;310
12.1.4;35.4 Radiographic Assessment;310
12.1.5;35.5 Intraoperative Assessment;311
12.1.6;35.6 Arthroscopic Assessment;311
12.1.7;35.7 Treatment;312
12.1.8;35.8 The Authors’ Preferred Method;313
12.1.9;35.9 Conclusion;315
12.1.10;References;315
12.2;36: Minimally Invasive Fixation of Complex Intra-articular Fractures of the Distal Tibial Plafond;317
12.2.1;36.1 Conclusion;323
12.2.2;References;323
12.3;37: Arthroscopic-Assisted External Fixation of Pilon Fractures;325
12.3.1;37.1 Introduction;325
12.3.2;37.2 Classification;325
12.3.3;37.3 Imaging;327
12.3.4;37.4 Treatment;327
12.3.4.1;37.4.1 Initial Evaluation;327
12.3.4.2;37.4.2 Treatment Principles;327
12.3.4.3;37.4.3 Surgical Technique;328
12.3.5;37.5 Conclusion;330
12.3.6;References;331
12.4;38: Treatment of Tibia Pilon Fractures with the Ilizarov Method;332
12.4.1;38.1 Introduction;332
12.4.2;38.2 Surgical Technique;333
12.4.3;38.3 Results;334
12.4.4;38.4 Discussion;334
12.4.5;38.5 Conclusion;336
12.4.6;References;336
12.5;39: Malleolar Fractures: Guidelines and Tips for Surgical Fixation;338
12.5.1;39.1 Introduction;338
12.5.2;39.2 Malleolar Fractures;340
12.5.2.1;39.2.1 Lateral Malleolar Fractures;340
12.5.2.2;39.2.2 Medial Malleolar Fractures;342
12.5.2.3;39.2.3 Posterior Malleolar Fractures;345
12.5.3;39.3 The Use of Arthroscopy in Malleolar Fractures;346
12.5.4;References;347
12.6;40: The Role of Arthroscopy in the Management of Fractures Around the Ankle;353
12.6.1;40.1 Introduction;353
12.6.1.1;40.1.1 Anterior Portals (Most Commonly Used Portal);355
12.6.1.2;40.1.2 Posterior Portals;355
12.6.1.3;40.1.3 Preoperative Planning;355
12.6.1.4;40.1.4 Arthroscopic Examination of the Ankle Joint;356
12.6.1.5;40.1.5 Technique;356
12.6.1.6;40.1.6 Arthroscopic-Assisted Reduction of the Fracture and Fixation (Bonasia et al. 2011; Gumann and Hamilton 2011; Turhan et al. 2013);357
12.6.1.6.1;40.1.6.1 Medial Malleolar Fracture;357
12.6.1.6.2;40.1.6.2 Lateral Malleolar Fixation;357
12.6.1.6.3;40.1.6.3 Bimalleolar Fractures;358
12.6.1.7;40.1.7 Maisonneuve Fracture (Imade et al. 2004; Jones et al. 2003; McGillion et al. 2007; Sri-Ram and Robinson 2005; Salvi et al. 2009)/Syndesmotic Injuries;358
12.6.1.8;40.1.8 Juvenile Intra-articular Epiphyseal Fractures (Imade et al. 2004; Jennings et al. 2007; Jones et al. 2003; McGillion et al. 2007);359
12.6.2;40.2 Figures 40.7 and 40.8: Talar Lesions (Gholam et al. 2000; Subairy et al. 2004; Thordarson et al. 2001a);360
12.6.3;40.3 Tibial Plafond Fractures;361
12.6.3.1;40.3.1 Postoperative Management;361
12.6.4;40.4 Discussion;361
12.6.5;40.5 Conclusion;362
12.6.5.1;40.5.1 Tips and Pearls for Effective Arthroscopy for Ankle Fracture (Hepple and Guha 2013; Thordarson et al. 2001b);362
12.6.6;References;363
12.7;41: Minimally Invasive Management of Osteochondral Defects to the Talus;365
12.7.1;41.1 Introduction;365
12.7.2;41.2 Historical Perspective;366
12.7.3;41.3 Non-surgical Management;366
12.7.4;41.4 Surgical Management;367
12.7.4.1;41.4.1 Arthroscopic Bone Marrow Stimulation (BMS);367
12.7.5;41.5 Retrograde Drilling;368
12.7.6;41.6 Osteochondral Fragment Fixation;368
12.7.6.1;41.6.1 Surgical Technique: Arthrotomy;368
12.7.7;41.7 Surgical Technique: Arthroscopic Lift, Drill, Fill and Fix (LDFF) Procedure;369
12.7.8;41.8 Osteochondral Fragment Fixation: Postoperative Management;370
12.7.9;41.9 Osteochondral Fragment Fixation: Results;371
12.7.10;41.10 Minimally Invasive Replacement Surgery for Talar OCDs after Failed Primary Surgery;371
12.7.11;41.11 Arthroscopic Cartilage Transplantation: Technique and Results;372
12.7.12;41.12 Minimally Invasive Osteochondral Transplantation Procedures;372
12.7.13;41.13 Conclusion;373
12.7.14;References;373
12.8;42: Talar Neck Fractures;376
12.8.1;42.1 Anatomy;376
12.8.2;42.2 Mechanism of Injury;378
12.8.3;42.3 Clinical Assessment;379
12.8.4;42.4 Imaging;379
12.8.5;42.5 Classification;380
12.8.6;42.6 Indications and Contraindications;381
12.8.7;42.7 Preoperative Planning;382
12.8.8;42.8 Treatment;382
12.8.9;42.9 Surgical Technique;383
12.8.10;42.10 Arthroscopic Treatment of Talar Neck Fracture;385
12.8.11;42.11 Operative Technique;385
12.8.12;42.12 Pearls and Pitfalls;385
12.8.13;42.13 Postoperative Management;386
12.8.14;42.14 Results and Complications;386
12.8.15;42.15 Functional Outcome;387
12.8.16;42.16 Conclusion;388
12.8.17;References;388
13;Part VII: Miscellaneous;390
13.1;43: Simulation Training and Assessment in Fracture Treatment;391
13.1.1;43.1 Introduction;391
13.1.2;43.2 The Evolution of Virtual and Augmented Reality for Educating Surgeons;392
13.1.3;43.3 Surgical Training;393
13.1.4;43.4 Conclusion;395
13.1.5;References;395
13.2;44: Return to Play After Intra-articular Knee Fractures;397
13.2.1;44.1 Introduction;397
13.2.2;44.2 Distal Femur Fractures;397
13.2.2.1;44.2.1 Tibial Eminentia Fracture;398
13.2.2.2;44.2.2 Patella Fractures;399
13.2.2.3;44.2.3 Tibial Plateau Fractures;400
13.2.3;44.3 Tibial Tuberosity Avulsion Fractures;401
13.2.4;44.4 Conclusion;401
13.2.5;References;402
14;Index;404